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Emergency Medical Minute


Oct 30, 2019

Author: Don Stader, MD

Educational Pearls:

  • Suboxone, methadone, and naltrexone are commonly used as treatments for opiate use disorder. 
  • Naltrexone is a full mu-opiate receptor antagonist, making acute pain control difficult in patients taking it. 
  • Options for pain control in patients on naltrexone include nerve blocks, NSAIDS, ketamine, and high doses of opiates. 
  • Of the opiates, Dilaudid (hydromorphone) has the highest affinity for mu-opiate receptors, and will be the most effective.


Vickers AP, Jolly A. Naltrexone and problems in pain management. BMJ. 2006;332(7534):132–133. doi:10.1136/bmj.332.7534.132


Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD